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 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The timely facilitation of immunologic (immunoglobulin or vaccine) or antimicrobial prophylaxis is used in individuals who have been exposed to certain infectious diseases. Such methodology has been shown to be helpful in infections such as viral hepatitis types A and B, measles, varicella, rabies, and tuberculosis. The data supporting such use in rubella and mumps are not strong and information is still needed in hepatitis C, human immunodeficiency virus, and Lyme borreliosis. This article reviews postexposure prophylaxis in these situations. Preventive strategies for meningococcal disease, group A streptococcus, tetanus, diphtheria, and pertussis are discussed elsewhere in this issue.
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PMID:Postexposure prophylaxis. 895 74

The current status and future prospects of vaccines for adults are discussed. For every child in America who dies of a vaccine-preventable disease, about 400 adults die of such a disease. Evidence of the merit of influenza vaccination continues to accumulate, yet < 30% of high-risk people younger than 65 have been vaccinated. Use of pneumococcal vaccine lags behind that of influenza vaccine. Serious discrepancies in immunization levels exist among different segments of U.S. adult society. A vaccination status assessment is now recommended for everyone reaching the age of 50. New vaccines are available to prevent varicella, hepatitis A, and typhoid fever. There are now two formulations of hepatitis A virus vaccine; adult users of these vaccines include travelers, people relocating to areas with poor sanitation, military personnel, laboratory workers, and hemophiliacs. New rabies vaccines may be the next vaccines to be used primarily in adults. Vaccines against pertussis, Lyme disease, cholera, herpes simplex, malaria, other infectious diseases, and cancer are in various stages of development. For health care personnel in areas where there is a strong likelihood of Mycobacterium tuberculosis transmission and infection, BCG vaccination is recommended. The risk of immunization to a person infected with the human immunodeficiency virus is likely outweighed by the protection offered against other health threats. Health systems should select tetanus-diphtheria toxoids adsorbed for their formularies for immunizing adults, not monovalent tetanus toxoid. Vaccines are available to prevent a growing list of infectious diseases but are underused in adults.
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PMID:Status and future of vaccines for adults. 904 59

Eight hundred and twelve children, 12 months to 3.5 years of age, were enrolled in two clinical studies to evaluate the safety and immunogenicity of a live, attenuated combination vaccine for measles, mumps, rubella, and varicella (MMRV). Children were enrolled in one of two randomized, multicenter studies, involving administration of (1) MMRV and placebo vs. measles, mumps, and rubella vaccine (M-M-R(II)) and varicella-zoster virus vaccine (VARIVAX), given at separate anatomic sites at the same office visit; or (2) MMRV, DTaP (diphtheria, tetanus, and acellular pertussis vaccine) and OPV (oral polio vaccine) vs. M-M-R(II), DTaP, and OPV, with VARIVAX given 6 weeks later. All vaccine regimens were generally well tolerated. More than 95% of vaccinees seroconverted for measles, mumps, rubella, and varicella, regardless of the vaccine or regimen used. In each study, the level of antibody titer to varicella virus was significantly lower in vaccinees receiving MMRV than in those who received VARIVAX in a separate syringe.
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PMID:Measles, mumps, rubella, and varicella combination vaccine: safety and immunogenicity alone and in combination with other vaccines given to children. Measles, Mumps, Rubella, Varicella Vaccine Study Group. 914 94

New prophylactic or treatment options are available for a number of infectious diseases that may be transmitted in the health care setting. Infectious diseases that can now be prevented by vaccination of the employee include hepatitis A, pertussis, hepatitis B, and primary varicella. New prophylactic or treatment regimens are available for Neisseria meningitidis, Streptococcus pyogenes, and Bordetella pertussis; treatment of multidrug-resistant tuberculosis is also discussed. Finally, management of the HIV-infected health care worker is reviewed.
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PMID:Frontiers of occupational health. New vaccines, new prophylactic regimens, and management of the HIV-infected worker. 918 49

In the introduction achievements of obligatory applied vaccines are described. Data on new vaccines for wide application are presented: acellular pertussis vaccine, Haemophilus influenzae b vaccine, hepatitis B vaccine and varicella (zoster) vaccine. For each vaccine data on immunity, protection and side effects are presented. Indications (epidemiological, illness severity) justifying vaccination as a method of protection from infection with a distinctive causative agent are presented. Antigen structure is given for each vaccine. Finally the form of application and age of primovaccination and revaccination are given. The conclusion is that these vaccines give high immunity and protection like those already in wide (obligatory) usage, and have less side effects.
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PMID:[New vaccines for wide usage]. 929 41

Family physicians can prevent the spread of some infections in their patients by assessing immunization status and administering the appropriate vaccines. Several changes in the recommended schedule for vaccine administration have occurred in the past few years: a vaccine for varicella is now available, and acellular pertussis vaccine is now recommended in children, starting at two months of age. Inactivated poliovirus immunization is recommended for consideration in the general population, not just in select groups. Current knowledge of the recommended vaccine schedules, as well as the controversies relating to these recommendations, will help family physicians make decisions about immunization practices for their patients.
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PMID:Immunizations: current recommendations. 957 17

Health care workers may be exposed to a variety of infections as they carry out their job responsibilities. Guidelines have been issued for prophylaxis following exposure to blood or body fluids known to be infected with the human immunodeficiency virus. Hepatitis B vaccine must be offered to all workers who may be exposed to blood and body fluids. Chemoprophylaxis is not available for workers exposed to hepatitis C. Health care facilities must conduct a tuberculosis risk assessment, provide skin testing at least yearly and develop isolation procedures for potentially infectious patients. The Occupational Safety and Health Administration currently mandates two-stage skin testing for all new employees at risk for tuberculosis exposure who have not had a skin test in the past year. Recent skin-test converters should be evaluated for isoniazid prophylaxis after a chest radiograph rules out active tuberculosis. Workers should be removed from the workplace from days 10 to 21 following exposure to varicella infection; vaccination of nonimmune workers should be considered. Because of possible side effects, the standard pertussis vaccine is not used in adults, but a new acellular pertussis vaccine has been effective in this group.
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PMID:Occupational infections in health care workers: prevention and intervention. 940 14

Better knowledge of the pathogenesis of infections and host responses, and progress in biotechnology, have paved the way for new vaccines. In spite of rapid progress with several vaccine candidates, overoptimism is, however, not warranted. There is usually several years' delay before the new vaccine from the laboratory is available in practice. Acellular pertussis vaccine and rotavirus vaccine are examples of new vaccines that are currently being introduced; varicella, inactivated polio, and hepatitis B vaccines have been suggested for use in a new and more efficient way. In order to keep up high motivation among families and thus high vaccination coverage, more emphasis must be put on information about vaccines, their properties and proper use. Economic analyses are becoming more important in the decision to use new vaccines. Therefore, cost-benefit, cost-effectiveness and cost-utility analyses need to be conducted so that a basis can exist for determining a rational policy.
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PMID:Childhood immunisation today. 961 91

To examine a possible relationship between infectious diseases and multiple sclerosis (MS) an enquiry was carried out among 606 MS patients in Switzerland. The data concerning their infectious childhood diseases were compared with epidemiological data for the normal Swiss population obtained from the Swiss Federal Health Office and from the Institute of Medical Statistics. The mean age of the MS patients was 50.7 years and the mean age at onset of multiple sclerosis was 33.8 years, significantly earlier in women (33.2 years) than in men (35.4 years, p < 0.05). In 18.8% multiple members of the family were affected. In comparison with persons of the control population, MS patients had measles infection at a later age (6.4 vs. 7.5 years). The curve of the age at which several infectious childhood diseases occurred was shifted to higher ages for MS patients (p < 0.005) compared to normal controls for mumps (80.2% for MS vs. 64.1% for controls in the age group 5-14 years), rubella (64.3% for MS vs. 48.4% for controls in the age group 5-14 years) and varicella (81.9% for MS vs. 39.0% for controls in the age group 5-19 years). For pertussis, however, there were more cases among those who later developed MS in the age group 1-9 years, which was earlier than in controls (86.0 vs. 56.7%). These results are compatible with the hypothesis that the risk of developing multiple sclerosis may be associated with acquiring certain infectious childhood diseases at a later stage in comparison to normal controls.
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PMID:Multiple sclerosis and infectious childhood diseases. 964 21

The present study was designed to investigate the hypothesis that febrile infectious childhood diseases (FICDs) are associated with a lower cancer risk in adulthood, since biographical considerations are of great importance in anthroposophic medicine. Cancer patients and control patients of 35 anthroposophic general practitioners in Switzerland were matched with respect to gender, age and physician. All patients completed a questionnaire on their FICD. We collected 424 cases; of these we could analyze 379 matched pairs. The study consistently revealed a lower cancer risk for patients with a history of FICD. The strongest associations were found between patients with non-breast cancers and rubella respectively chickenpox. A strong association was also found with the overall number of FICD both 'classical' (measles, mumps, rubella, pertussis, scarlet-fever and chickenpox) and 'other'. None of these associations was apparent for patients with breast cancer. Unexpectedly, we found that cancer was diagnosed significantly earlier in life in cancer patients with a history of FICD compared to those without FICD. Our retrospective study showed a significant association between FICD and the risk of developing cancer. The number of FICD decreased the cancer risk, in particular for non-breast cancers. The relationship with tumor site seems to be important also, but can only be addressed in a larger study.
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PMID:Febrile infectious childhood diseases in the history of cancer patients and matched controls. 982 38


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